Sue Anne Boatman, Regina Ginn , Leilani Greening, Kris Harrell, Shane McNeill, and Wanda Porter

1. Sue Anne Boatman, Regina Ginn, Leilani Greening, Kris Harrell, Shane McNeill, and Wanda Porter

2. Acknowledgements

3. Objectives of the Presentation • To discuss the background, goals, objectives, methods, and results of the T.E.A.M. Mississippi childhood obesity project • To share stories and reflect upon sustainable elements of the project • To describe future implications and further development of the project

4. Background • Mississippi leads the nation with the highest prevalence rate of obesity, and is the first state to have an obesity rate greater than 30%. • Mississippi also has one of the highest rates of childhood obesity, currently around 18%. healthyamericans.org

5. Our Partnership • T.E.A.M. Mississippi • Teachers, Elementary schools, Academic institutions, and Mothers • The MS Department of Education and the University of MS Medical Center • Team(traditional definition) • n. a group organized to work together • teams are designed to operate in such a way that productivity of the whole is greater than the sum of its parts The American Heritage® Dictionary of the English Language4th Edition. Houghton Mifflin Company, 2004. www.themanager.org

6. Our Goal and Objectives • Main goal is to reduce Mississippi’s prevalence of overweight, obesity, and their complications • Specific objectives of the program: • to increase awareness of healthy behaviors • to improve nutritional and physical activity behaviors among elementary school children and their families

7. What Makes Our Project Unique • Project is in a small, rural, setting • Attempts to bridge the gap between school and the community by engaging families • Special focus on mothers and girls Our T.E.A.M. motto: “If momma ain’t healthy, ain’t nobody healthy!”

8. Intervention Methods • Initial groundwork at the community level • Site selection • Focus groups (teachers, PTO, community leaders, legislators) • Needs assessment (access to care, availability of healthy foods, infrastructure) • Family Olympics theme • Opening and closing ceremonies • Monthly Olympic events alternating with nutrition and physical activities that include participation from children and parents

9. Intervention Methods • Activities for Girls • Bodyworks training program • Girls’ night out • Women’s basketball coach from nearby university brought in to motivate girls to participate in physical activities and to discuss body image and self-esteem

10. Evaluation Methods • Two schools, Eupora Elementary (intervention) and Winona Elementary (control) • Similar in demographics • Close in proximity • Data collection in children and parents grades 1-4 before and after the 9-month intervention (school year) Approved by the University of Mississippi Medical Center Institutional Review Board with informed consent obtained from all participants

11. Evaluation Methods (cont’d) • Primary outcome measures • dietary habits (24 hr diet recall, Child Dietary Fat Questionnaire) • physical activity (SPARK activity list, and President’s Challenge) • nutrition knowledge (Know Your Body questionnaire) • biomarkers (BMI percentile, waist circumference, and body fat) • Secondary outcome measures • Parental dietary habits • Community impact

12. Results - Demographics

13. Results - Outcomes Body Fat (%) p < 0.05

14. Results - Outcomes Physical Activity – SPARK scores p < 0.05

15. Results - Outcomes Physical Activity – Curl Ups (#) p < 0.05

16. Results - Outcomes Physical Activity – Shuttle Run (sec) p < 0.05

17. Results - Outcomes Child Dietary Scores from CDFQ p < 0.05

18. Results - Outcomes Parent Dietary Scores from CDFQ p < 0.05

19. Results – Outcomes Body Mass Index p > 0.05

20. Results – Gender and Race There were no gender or racial differences in the treatment effects. However, there was a trend for the racial gaps to start to narrow down.

21. Sustainable Efforts at the School Level • Recipients of School Health Grants - 5-Star Grant, Nutrition Integrity, Health Is Academic Start-Up Grant, EPSDT School Nurse, 3-A-Day Dairy • Nutrition changes • Removal of deep fryers and purchase of combination oven / steamer • Concession stand changed to cafeteria based healthy snacks • Physical activity changes • Implemented 2-minute exercises during classes or 5-minute walks • Enhanced physical education in the gym and now teacher collecting data • Installation of walking track

22. Sustainable Efforts at the School Level • Other noticeable related changes • Health curriculum integrated into classrooms • Partnerships- MSU Extension Office • Increased collaboration with high school • Increased community visibility • Increased teacher motivation • Increased parental involvement

23. Our Stories

24. Future Implications • Telling our stories • Statewide and nationally • Dissemination amongst education leaders • T.E.A.M. manual development • Make available on the Office of Healthy Schools website • Provide a CD with specific examples • Incorporate with other ongoing efforts • CDC comprehensive coordinated school health • Provide consultant services for each district • Encourage body fat % as another collected measure